Sedatives And General Anesthetics

Question 1

What is the difference between sedatives and hypnotics drugs?

Answer 1

Sedative: produce calming effect + reduce anxiety (anxiolytic).
Hypnotics: encourage onset and maintenance of sleep.

Question 2

Which group of sedatives is more likely to cause cardiovascular and respiratory depression?

Answer 2

Barbiturates

Question 3

Describe the MOA of barbiturates and benzodiazepines in the treatment of anxiety?

Answer 3

1- bind to GABA receptors and activate them.
2- entry of Cl ions into the cell.
3- leading to inhibition of the signals in the postsynaptic neurons.(hyperpolarization).

Question 4

List two ultra short acting benzodiazepines?

Answer 4

Triazolam + midazolam

Question 5

What is the class of duration of action of lorazepam?

Answer 5

Short acting benzodiazepine

Question 6

A sedative used for GADs and it is medium acting.

Answer 6

Alprazolam

Question 7

How does benzodiazepines induce sleep?

Answer 7

Decrease time to get to sleep + increase total duration of sleep

Question 8

Selective benzodiazepine drug associated with sedation but NOT anxiety.

Answer 8

Zolpidem

Question 9

Antidote of benzodiazepines (antagonist).

Answer 9

Flumzenil

Question 10

What is the clinical use of thiopentone (barbiturate)?

Answer 10

Used for the induction anesthesia

Question 11

What is the clinical use of pentobarbitone (barbiturate)?

Answer 11

Antiepileptic

Question 12

What are the characteristics of an ideal general anesthetic?

Answer 12

1- Hypnosis.
2- Analgesia.
3- Muscle relaxation.
4- Rapid induction and recovery.

Question 13

List three volatile general anesthetics?

Answer 13

Halothane - isoflurane -chloroform

Question 14

A non-volatile general anesthetic.

Answer 14

Chloral hydrate

Question 15

The does the general anesthetics works?

Answer 15

1- enhance the inhibitory signaling by activation of GABA A receptors.
2- inhibit the excitatory signaling by inactivation of NMDA receptors.

Question 16

What are the physiochemical properties that determine the inhaled anesthetics activity?

Answer 16

1- Blood solubility (induction onset and recovery duration).

2- Fat solubility (potency).

Question 17

What are the physiological factors that affect the activity of the inhaled anesthetics?

Answer 17

Cardiac output + Ventilation rate

Question 18

Which anesthetic induce anesthesia faster?

Halothane or Nitrous oxide

Answer 18

Nitrous oxide (it is less soluble)

Question 19

Ultra short barbiturate anesthetic, but has a transient effect as it redistribute readily.

Answer 19

Thiopentone

Question 20

Short acting BDZs anesthetic used as a strong sedative, but has little risk of respiratory depression.

Answer 20

Midazolam

Question 21

IV anesthetic, has antiemetic effect and can cause hypotension.

Answer 21

Propofol

Question 22

IV anesthetic, has no analgesic effect, it is used for patients with limited cardiac / respiratory reserve.

Answer 22

Etomidate